Frequently Asked Questions

Why should we genetically screen our embryos? And does my insurance cover this?

Pre-implantation genetic testing is a technique in which one or more cells is taken from an embryo for testing to provide information about the genetic make-up of the rest of the cells in that embryo. Testing typically takes place 5 days after the egg has been harvested and fertilized in an in vitro fertilization (IVF) laboratory.

Experts recommend genetic testing for couples undergoing fertility testing, particularly before IVF. It can detect several inherited diseases, such as a history of single-gene disorders (i.e., cystic fibrosis or sickle cell anemia) and or sex-linked disorders (i.e., Duchenne muscular dystrophy and Fragile X syndrome). Genetic screening may also be indicated for those with recurrent pregnancy loss or severe male factor infertility.

Insurance does not typically cover this but with infertility awareness and coverage increasing, this could change.

What time of the month is a woman most fertile?

For a woman who has a normal 28-day cycle, day 14 is typically when ovulation occurs. Once released, the egg is viable for up to 24 hours, but the fertilizability decreases after 4-6 hours, making this the most fertile time. However, not every woman ovulates regularly. Cycles and fertile windows depend on the individual, which is why we feel a personalized care plan is the best approach.

My AMH (anti-Müllerian hormone) was low. Can I improve my ovarian reserves?

Decreasing AMH values is a natural process that usually cannot be prevented. AMH is a lab test so variations are expected. It is important to know that AMH cannot be used to predict fertility. It is mainly used by the doctor to guide how much medication should be used during ovarian stimulation. Many medications have been used to try to increase AMH values, but none have worked. Treatment with stem cells, platelet-rich plasma (PRP) and stem cell derived exosomes have been reported to increase AMH. Learn more about stem cell therapy and stimulation here.

Can I improve my egg quality?

We are not sure if the egg quality consistently gets better, but we use vitamins, coenzyme Q10 (CoQ10), and niacinamide. Stem cell therapy can also potentially improve egg quality.

How do I know if I need an egg donor?

If you have no periods and are post-menopausal, an egg donor is a good choice. If multiple in vitro fertilization (IVF) stimulations have been performed and all eggs are abnormal, this is also something that could be used as an indication to use an egg donor. In addition, genetic considerations may lead you to choose an egg donor. Click here to learn more about donor eggs.

How do I know if I need a sperm donor?

If there is no sperm in the ejaculate and the surgical microscopic sperm retrieval yield no sperm, a sperm donor is needed. If there are severely abnormal sperm that do not fertilize through in vitro fertilization (IVF), that is another reason to choose a sperm donor. Genetic factors can also be considered. You can learn more about donor sperm here.

How do I know if I need to use a gestational surrogate?

If you are in a male/male relationship, both an egg donor and a surrogate is needed. The eggs are not expected to come from the gestational surrogate. Other reasons to use a gestational surrogate include the absence of a uterus, an abnormal uterus (i.e, severely distorted by fibroids), multiple miscarriages because of immune reactions, or severely complicated pregnancies. You can learn more about gestational surrogacy here.

If I have been on birth control for years, will this make me less fertile?

Birth control pills do not affect fertility. However, if you have been on birth control pills for a long time, you have become older, and age is a significant factor in the ability to become pregnant.

What are exosomes?

Exosomes are small vesicles (30-150 nm), which are thin-walled sacs filled with fluid, secreted from all cells in the body. They work as a communication system between cells. We are particularly interested in exosomes from stem cells which carry factors that stimulate and renew cells throughout the body. You can learn more here.

Is there a hormone-free way to treat vaginal dryness?

Vaginal lubricants such as Replens and others can be used to treat vaginal dryness. New techniques such as laser and radiofrequency of the urethra and surrounding vaginal tissue are becoming more popular and work well for long-term improvement. Injections of stem cells and exosomes into the urethra and the lower bladder area are also techniques that can be tried.

Is there a pain-free solution for urinary incontinence that does not require medication?

We can try injections of stem cells and exosomes into the urethra and the lower bladder area. Radiofrequency of the urethra and surrounding vagina tissue in women also works well. If the effect of the radiofrequency is waning, repeat procedures can return the tissue to normal.

If I had a miscarriage, will I be more likely to have another?

One out of 6 pregnancies result in a miscarriage, so it is a very common experience even if it is rarely discussed. Statistically, it is much more likely that the next pregnancy will be successful since most miscarriages are caused by chromosome abnormalities. However, the risk for miscarriages increases with age. When two or more miscarriages have occurred, the medical term “habitual abortion,” is used, and you should seek a more thorough examination. Click here to learn more about infertility diagnosis and testing at Friberg Fertility.